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Found 798 results
  1. News Article
    Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows. Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades. It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure. Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram. Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers. Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system." “The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added. Read full story (paywalled) Source: The Times, 5 October 2023
  2. Content Article
    Aortic valve replacement (AVR) is a life-saving procedure for symptomatic severe aortic stenosis (AS), which relieves symptoms, increases life expectancy and improves quality of life. Little is known about the rate of AVR provision by gender, race or social deprivation level in the NHS across England. However, a large analysis examining AVR on the health service in England – the first of its kind – reveals striking inequalities in its provision. Women, black and Asian people, and those living in the poorest parts of the country are much less likely to receive the life-saving procedure, the study shows. “In this large, national dataset, female gender, black or south Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England,” the authors wrote. Dr Clare Appleby, a consultant cardiologist at the Liverpool Heart and Chest hospital NHS foundation trust and an author of the study, said public health initiatives to understand and tackle these inequalities should be prioritised. “Severe symptomatic aortic stenosis is a serious disease that causes mortality and reduces quality of life for patients,” she said. “Left untreated it has a worse prognosis than many common metastatic cancers, with average survival being 50% at two years, and around 20% at five years.” Further research and public health initiatives to understand and address inequalities in the timely provision of AVR are important and should be prioritised in England.
  3. News Article
    Thousands of women may be missing out on a diagnosis of type 2 diabetes because the thresholds are geared towards men, research suggests. Scientists assessed test results from more than one million patients across the country and concluded that the bar for diagnosis might be set too high for women. They calculated that, if thresholds were lowered slightly, an extra 35,000 women under the age of 50 in England would be diagnosed with type 2 diabetes — increasing the number in this age group with the condition by 17%. Under the present guidelines, those 35,000 women would be given the all-clear and would miss out on the chance of earlier treatment and lifestyle advice, increasing their risk of complications in later life. The team, led by doctors at the University of Manchester and including researchers from hospitals nationwide, stressed that their findings were preliminary, and needed further assessment before their hypothesis was confirmed. But, if proved correct, they believe that about 65 young women may be dying of diabetes each year without a diagnosis. Read full story (paywalled) Source: The Times, 1 October 2023
  4. Content Article
    Women interact with cancer in complex ways, as healthy individuals participating in cancer prevention, as patients, as health professionals, researchers, policymakers, and as unpaid caregivers. In all these domains, women often are subject to overlapping forms of discrimination, such as due to age, race, ethnicity and socio-economic status, that render them structurally marginalised. These myriad factors can restrict a woman’s rights and opportunities to avoid cancer risks, are a barrier to diagnosis and quality cancer care, maintain an unpaid caregiver workforce that is predominantly female, and hinder women’s professional advancement.
  5. Content Article
    Mental health in the UK is getting worse. Sickness absence due to mental illness is soaring, rates of mental health difficulties are increasing at an alarming rate, and already overstretched services are struggling to meet rising demands. Along with over 30 organisations with an interest in mental health, the Centre for Mental Health has developed a plan to address this and build a mentally healthier nation.
  6. Content Article
    In April 2023, National Voices held a workshop with members, supported by The Disrupt Foundation, on the unequal impact of the Covid-19 pandemic. It explored how communities and groups were affected differently by both the virus itself and the measures brought in to control it.   It painted a grim picture of the ways in which the pandemic response exacerbated existing, deep-rooted inequalities across the UK and compounded the disadvantages experienced by people from minoritised communities, by disabled people and by people living with long term conditions.  Just some examples include people who are immunocompromised, who were asked to go into isolation for huge periods of time and still feel completely overlooked as control measures have been lifted. Or the use of DNRs (Do Not Resuscitate orders) which were disproportionately applied to people with learning disabilities.  With the Covid-19 Inquiry underway, it is imperative that we capture the lessons learnt from the pandemic, and use them to suggest action for the future.
  7. Content Article
    In this article, inews columnist Kate Lister looks at the andropause, sometimes called the 'male menopause' that can affect men in their later 40s and early 50s. A gradual decline in testosterone levels can contribute to some men developing depression, loss of sex drive, erectile dysfunction and other physical and emotional symptoms. She looks at current research and views around the issue, highlighting her own bias in initially dismissing the idea and linking this to the societal notion that 'only women are hormonal'. She highlights that although the drop in testosterone men experience is not like the sudden hormonal changes that causes the menopause, men can still experience severe symptoms that require treatment with hormone therapy. "Despite my scoffing at the idea, it turns out that the andropause is very much a real thing that can impact some men very badly. The treatment is exactly the same as it is for women struggling with menopause and perimenopause. It’s hormone replacement therapy: this time in the form of testosterone."
  8. Content Article
    If the NHS doesn't fund the medical treatment you need in your area, or you are unhappy about where you are going to be treated on the NHS, you have the legal right to go elsewhere and still be treated by the NHS, even if it's outside your local NHS Trust area. In this short blog, patient Verite Reily Collins writes about the rights patients have to choose where they receive their care, and how this may help overcome barriers in access to treatment.
  9. Content Article
    The latest data from the Office for National Statistics (ONS) provides the most comprehensive and up to date national profile of ethnic inequalities in mortality overall and from common physical conditions. It shows a complex picture of ethnic inequalities in mortality in England, with differences between people from ethnic minority and the White British groups, between different ethnic minority groups, and across different health conditions. This King's Fund blog looks at the complex interplay of factors drives ethnic differences in health.
  10. Content Article
    In this webinar recording, Alex RK, a barrister, writer and educator, takes stock of the mental capacity and mental health law and policy landscape as at August 2023. It primarily focuses on England & Wales, but also includes developments in the UK and further afield, including thinking about the implications of the French language version of Article 19 CRPD providing not for ‘living independently’, but ‘autonomie de vie’.
  11. Content Article
    The Maternal, Newborn and Infant Clinical Outcome Review Programme, which is delivered by MBRRACE-UK, has published a report on UK Perinatal Deaths for Births from January to December 2021. Overall, it found that perinatal mortality rates increased across the UK in 2021, with 3.54 stillbirths per 1,000 total births and 1.65 neonatal deaths per 1,000 live births (3.33 and 1.53 respectively in 2020). However, there was a wide variation in stillbirth and neonatal mortality rates across organisations, though these rates increased in almost all gestational age groups. It was also found that inequalities in mortality rates by deprivation and ethnicity remain, but the most common causes of stillbirth and neonatal death are unchanged (for example, congenital anomalies continue to contribute to a significant proportion of perinatal deaths).
  12. Content Article
    Event analysis is a valuable tool to improve patient safety and quality of care by identifying root causes of incidents and implementing corrective actions to prevent future similar events from occurring. When we analyse adverse events in healthcare and do not incorporate an equity lens, however, we are missing a crucial piece of the investigative puzzle. Health equity is essential to improving health and well-being and can be costly if not addressed as explained in this Institute for Healthcare Improvement (IHI) blog
  13. Content Article
    The USA President’s Council of Advisors on Science and Technology have released their report to the US President, Joe Biden, on patient safety. The report contains recommendations aimed at dramatically improving patient safety in Amercia.
  14. Content Article
    From endometriosis to heart attacks, this Guardian article look into the causes and symptoms, and explore gender disparities in quality of care
  15. News Article
    Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child. But, just five weeks after confirming her pregnancy she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain. “I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.” An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby. Black women are less likely than women from other racial groups to carry a pregnancy to term — and in Harris County, where Houston is located, when they do, their infants are about twice as likely to die before their 1st birthday as those from other racial groups. Black fetal and infant deaths are part of a continuum of systemic failures that contribute to disproportionately high Black maternal mortality rates. “This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.” Read full story Source: KFF Health News, 24 August 2023
  16. Content Article
    Patients have better outcomes with female surgeons, a study from Wallis et al. has found. In a cohort study of 1 million patients, those treated by a female surgeon were less likely to experience death, hospital readmission, or major medical complication at 90 days or 1 year after surgery. This association was seen across nearly all subgroups defined by patient, surgeon, hospital, and procedure characteristics.
  17. News Article
    An NHS body is encouraging women with breast cancer from minority backgrounds to take part in more clinical trials, after research found they are under-represented in studies that can offer life-saving treatment. The pilot project, supported by the NHS Race and Health Observatory, is intended to improve representation in breast cancer clinical trials partly through culturally sensitive communications to people from racially diverse backgrounds. Research from the UK Health Security Agency suggests young black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research. Their lack of inclusion in trials could be partly down to distrust of the research process and a lack of knowledge, according to research by the UK’s National Institute for Health Research. The project, which works in conjunction with Macmillan Cancer Support and the pharmaceutical company Roche, will run for a year and look at developing new ways for people with breast cancer to access clinical trials. It will develop action plans to improve representation and provide enhanced support for patients. Read full story Source: The Guardian, 31 August 2023
  18. News Article
    In the most deprived areas of England and Scotland, the nearest 24/7 accessible defibrillator is on average a round trip of 1.8 km away—over a mile—according to a pioneering study supported by the British Heart Foundation (BHF). The researchers, led by Dr Chris Wilkinson, senior lecturer in cardiology at Hull York Medical School, used data from national defibrillator network The Circuit to calculate the median road distance to a defibrillator with unrestricted public access across Great Britain's 1.7 million postcodes. Among the 78,425 defibrillator locations included, the median distance from the centre of a postcode to a 24/7 public access defibrillator was 726.1 metres – 0.45 miles. In England and Scotland, the more deprived an area was, the farther its average distance from a 24/7-accessible defibrillator – on average 99 metres more in England, and 317 metres farther in Scotland for people living in the most compared with the least deprived areas. There was no link between defibrillator location and deprivation in Wales. The researchers said they hoped the findings, presented at the European Society of Cardiology (ESC) Congress in Amsterdam and published in the journal Heart, would lead to more equal access to defibrillators. They noted that there were over 30,000 out-of-hospital cardiac arrests (OHCA) annually in the UK; in England nearly 30% happened at weekends, and 40% between 6pm and 6am. Read full story Read research study: Automated external defibrillator location and socioeconomic deprivation in Great Britain (28 August 2023) Source: Medscape, 29 August 2023
  19. Content Article
    The early use of automated external defibrillators (AEDs) improves outcomes in out-of-hospital cardiac arrest (OHCA). This study in the journal Heart investigated AED access across Great Britain according to socioeconomic deprivation. The authors found that in England and Scotland, there are differences in distances to the nearest 24/7 accessible AED between the most and least deprived communities. They concluded that equitable access to ‘out-of-hours’ accessible AEDs may improve outcomes for people with OHCA.
  20. News Article
    The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas. The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend. The research findings include: ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments; “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”; Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.” Read full story (paywalled) Source: HSJ, 25 August 2023
  21. News Article
    The United States is in the middle of a maternal health crisis. Today, a woman in the US is twice as likely to die from pregnancy than her mother was a generation ago. Statistics from the World Health Organization show the United States has one of the highest rates of maternal death in the developed world. Women in the US are 10 or more times likely to die from pregnancy-related causes than mothers in Poland, Spain or Norway. Some of the worst statistics come out of the South - in places like Louisiana, where deep pockets of poverty, health care deserts and racial biases have long put mothers at risk. Dr Rebekah Gee: The state of maternal health in the United States is abysmal. And Louisiana is the highest maternal mortality in the US. So, in the developed world, Louisiana has the worst outcomes for women having babies." A third of Louisiana's parishes are maternal health deserts – meaning they don't have a single OB-GYN, leaving more than 51 thousand women in the state without easy access to care and three times more likely to die of pregnancy related causes. Read full story Source: CBS News, 20 August 2023
  22. Content Article
    People living in deprived areas experience the most significant health inequalities in terms of access, experience and outcomes. There are large reductions in life expectancy for those living in the most deprived areas compared to people living in the least deprived areas. NHS England commissioned a research project into access, experience and outcomes related to health services in socio-economically deprived communities. This communications and engagement toolkit is an output of the research. The toolkit is designed to be used by communications and engagement professionals and others across the NHS with a responsibility for communicating to and engaging with people in the most deprived areas. 
  23. News Article
    Hundreds of migrants have declined NHS treatment after being presented with upfront charges over the past two years, amid complaints the government’s “hostile environment” on immigration remains firmly in place. Data compiled by the Observer under the Freedom of Information Act shows that, since January 2021, 3,545 patients across 68 hospital trusts in England have been told they must pay upfront charges totalling £7.1m. Of those, 905 patients across 58 trusts did not proceed with treatment. NHS trusts in England have been required to seek advance payment before providing elective care to certain migrants since October 2017. It covers overseas visitors and migrants ruled ineligible for free healthcare, such as failed asylum seekers and those who have overstayed their visa. The policy is not supposed to cover urgent or “immediately necessary” treatment. However, there have been multiple cases of people wrongly denied treatment. Dr Laura-Jane Smith, a consultant respiratory physician and member of the campaign group Medact, said: “I had a patient we diagnosed as an emergency with lung cancer but they were told they would be charged upfront for treatment and then never returned for a follow-up. This was someone who had been in the country for years but who did not have the right official migration status. A cancer diagnosis is devastating. To then be abandoned by the health service is inhumane.” Read full story Source: The Guardian, 20 August 2023
  24. Content Article
    There is a well-established case for involving communities and people with lived experience in health and care policy, service design and delivery. NHS England guidance on working in partnership with communities highlights the financial benefits and improvements to quality and health outcomes that working with local communities brings. But could this involvement go further? In this article, Loreen Chikwira, Researcher at The King's Fund looks at the arguments for the use of intersectional approaches in understanding people’s lived experience of care in tackling ethnic health inequalities. These intersectional approaches help health and care providers shift their focus from people’s behaviours to also identifying and addressing ways of working that create and reinforce inequalities and poor experiences of care.
  25. Event
    until
    Professor Bola Owolabi, Director of the National Healthcare Inequalities Improvement Programme at NHS England, will be kicking off Patient Partnership Week 2023 on Monday 25th September. Prof Owolabi, who also works as GP in the Midlands, will be in conversation with Rachel Power, Chief Executive of the Patients Association. They'll be talking about the vital role partnerships with patients and communities play in tackling health inequalities. Sign up for this free event which will be held on Zoom About CORE20PLUS5 Prof Owolabi has spearheaded NHS England’s Core20PLUS5 approach to narrowing healthcare inequalities. Core20PLUS5 is a national approach to reducing healthcare inequalities. It defines a target population – the ‘Core20PLUS’ – and identifies ‘5’ clinical areas that require improvement. The Core20 refers to the most deprived 20% of the population. The PLUS are groups identified in a local area such as ethnic minority communities or people with multiple long-term health conditions. The 5 are these clinical areas: maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis, and hypertension.
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